Chapter 13: Nursing Care During Labor and BirthMULTIPLE CHOICE1.The nurse is preparing to perform Leopold’s maneuvers. Why are Leopold’s maneuvers used by practitioners?a.To determine the status of the membranesb.To determine cervical dilation and effacementc.To determine the best location to assess the fetal heart rated.To determine whether the fetus is in the posterior positionANS: CLeopold’s maneuvers are often performed before assessing the fetal heart rate (FHR). These maneuvers help identify the best location to obtain the FHR. A Nitrazine or ferning test can beperformed to determine the status of the fetal membranes. Dilation and effacement are best determined by vaginal examination. Assessment of fetal position is more accurate with vaginal examination.PTS:1DIF:Cognitive Level: ApplicationREF:227OBJ:Nursing Process Step: PlanningMSC:Client Needs: Health Promotion and Maintenance2.Which comfort measure should a nurse use to assist a laboring woman to relax?a.Recommend frequent position changes.b.Palpate her filling bladder every 15 minutes.c.Offer warm wet cloths to use on the client’s face and neck.d.Keep the room lights lit so the client and her coach can see everything.ANS: AFrequent maternal position changes reduce the discomfort from constant pressure and promotefetal descent. A full bladder intensifies labor pain. The bladder should be emptied every 2 hours. Women in labor get hot and perspire. Cool cloths are much better. Soft indirect lighting is more soothing than irritating bright lights.PTS:1DIF:Cognitive Level: ApplicationREF:236OBJ:Nursing Process Step: ImplementationMSC:Client Needs: Physiologic Integrity3.Which assessment finding could indicate hemorrhage in the postpartum patient?a.Elevated pulse rateb.Elevated blood pressurec.Firm fundus at the midlined.Saturation of two perineal pads in 4 hoursANS: AAn increasing pulse rate is an early sign of excessive blood loss. If the blood volume were diminishing, the blood pressure would decrease. A firm fundus indicates that the uterus is contracting and compressing the open blood vessels at the placental site. Saturation of one padwithin the first hour is the maximum normal amount of lochial flow. Two pads within 4 hours is within normal limits.PTS:1DIF:Cognitive Level: AnalysisREF:224

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OBJ:Nursing Process Step: AssessmentMSC:Client Needs: Physiologic Integrity4.Which is an essential part of nursing care for a laboring client?a.Helping the woman manage the painb.Eliminating the pain associated with laborc.Feeling comfortable with the predictable nature of intrapartal cared.Sharing personal experiences regarding labor and birth to decrease her anxietyANS: AHelping a client manage the pain is an essential part of nursing care because pain is an expected part of normal labor and cannot be fully relieved. Labor pain cannot be fully relieved. The labor nurse should always be assessing for unpredictable occurrences.

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